After six doses of epinephrine, it may be too late for the CPR patient. Emergency physicians Dr. Zachary Boivin and Dr. Trent She, both from Connecticut, discussed their recent study entitled "Epinephrine in Cardiac Arrest: Identifying a Potential Limit for Resuscitation."1 This research sought to determine if there is a ceiling to the effective use of Epinephrine during resuscitation.

Peter Antevy, MD, who created the Handtevy System, a software-based pediatric resuscitation method and bag system is also an EMS Physician for Palm Beach County (FL) Fire Rescue and he made a post on LinkedIn advocating for abolishing Epinephrine in shockable rhythm protocols. He posts about how his protocol does not follow standard AHA guidelines at Palm Beach County Fire Rescue and their plan for ventricular fibrillation is to use esmolol, but no Epinephrine.

References

1. Boivin, Z., Duignan, K. M., Doko, D., Pugliese, N., & She, T. (2023). Epinephrine in Cardiac Arrest: Identifying a Potential Limit for Resuscitation. Western Journal of Emergency Medicine, 24(6), 1025.